Heaven on the Pacific

As I have already had cause to mention, every week on this mission reveals to me a new dimension that brings into sharp focus the enormity and the impact of this mission on the people we are serving. We sailed for 3 days from Indonesia to Philippines, two days after I got back from my MEDCAP in Indonesia. We have been in Philippines for about ten days now. I spent the first week in Philippines working as an Inpatient Pharmacy Technician on the ship’s Pharmacy. My duty as an Inpatient Technician was help fill prescriptions for pre and post-surgical patients. I also prepared and delivered IVs to the various wards that housed these patients. I got a better idea of the valiant work that these selfless surgeons on the ship are doing while delivering medications to these wards. The number of patients we are serving aboard the ship and the complexity of the cases have blown me away! I have seen children with cleft pallets operated on and transformed. I have seen cataract patients successfully operated on among others. I have witnessed the immense gratitude of these patients and the palpable joy on their faces.

                                                               Making an IV

Perhaps my most humbling experience on this mission is the opportunity to observe a couple of surgeries at the operation room on Saturday the 23^rd of June 2012. Dr. Robert Baxt and Dr. Sharon Weintraub, both fellow Project Hope volunteers conducted both surgeries. The first surgery was a routine procedure to repair a right inguinal hernia on a 2-year old boy. The operation was hugely successful and after forty minutes under the surgeons’ scalpel, the little angel’s life was eternally transformed. He was in fact discharged from the hospital later that evening after a life-changing procedure that most probably averted a lifetime of pain and misery for the little boy. This assertion was given a further credence by the second surgery I witnessed that day. This was also a left inguinal hernia surgery on a 43-year old man. This procedure was anything but routine; it was a procedure to repair an 8-pound hernia the size of a large cantaloupe. According to the surgeons, it was pretty much the biggest one they have seen in their long time in practice. The patient has been carrying this hernia ever since childbirth and had not had the means to get it operated on till now. I fail to see how this patient could possibly have engaged in any physical activity prior to this surgery. Dr. Baxt pointed it out to me that this was the fate the little boy who was operated on earlier was looking at had he not been operated on. The surgical operation on this older patient took a little more than two hours to complete. It was the sort of procedure that will ordinarily make me queasy and uneasy. However my sense of curiosity and my eagerness to be a witness to this transformative procedure got the better of me and gave me the guts to stay through the whole of this rather graphic procedure. Observing these accomplished surgeons make an incision on the lower abdomen of the patient, pull all the parts of the patient’s gastrointestinal tract that had descended into the scrotal sac through the inguinal canal, causing this rather massive hernia, putting these parts of the tract back where they belong in the stomach, closing up the canal and stitching up the incision was surreal and humbling to say the least. The look of gratitude on the face of the patient as he woke up from his anesthesia, just before he was carted from the operating room to the recovery ward was priceless and will forever be ingrained in my mind. Life as known by this patient will never be the same again. He will be able to engage in activities that he had hitherto not been to partake in. His self-confidence and outlook in life will be hugely boosted all because a group of selfless and philanthropic individuals on a big hospital ship happen to stop by. I had wanted to visit this patient at the recovery ward to see how he was doing but was told by Dr. Baxt at dinner the next day that he had already been discharged earlier that day. I am really happy for this patient for his speedy recovery and the new lease of life he’s been given by this operation.

                                                                   At the OR

I also had the privilege to be on a Surgical Civic Action Program (SURGCAP) team on Sunday 24^th June 2012. This is a team that goes Inland to screen patients eligible for surgery on the ship’s operation rooms. On this day we travelled to Calbayog City in Philippines to conduct this screening exercise at the city’s sports complex. I was part of a team responsible for taking and recording the vital statistics of the patients to be screened. We were met by a large crowd at the gate of the complex waiting for the chance of a life-changing operation. We screened in excess of 450 patients on this day and booked 140 appointments for various surgical operations to be conducted at the ship’s operation rooms for the last week of our mission in Philippines. Even though we’re doing tremendous good on this mission, I still couldn’t help but feel bad for the numerous people we had to turn away because we didn’t have the capacity to take on more. I truly wish we had the capacity to help everybody who needed help but I also know that is unrealistic. What broke my heart perhaps was the story of this elderly lady who broke down in tears when she was given the bad news that we were unable to take on any more patients. She had ovarian cysts and recounted through an interpreter how she had travelled a long distance to be there in the hope of getting relief from her condition. According to her she has no means of obtaining care for her ailment and we were her last hope of ever getting her condition operated on. This rather sad story really did put a damp on my day but the realization that we have been able to offer relief for hundreds and will be able to do that for a few hundred more patients with similar stories did help me put it all in a better perspective.

                                                        Taking down vital stats

Alexis and I also had the opportunity to do a presentation on viral gastroenteritis for all the personnel at the Pharmacy department and other invited guests on Monday the 25^th of June 2012. We thought it was a relevant topic to present on because of the outbreak of gastroenteritis on the ship two weeks ago. In the presentation we educated our audience on the causes, epidemiology, pathophysiology, prevention and treatment of the disease.

This wonderful adventure is sadly on its last leg but its life-changing experiences will fuel me forever. Stay tuned as I wrap up on this awesome adventure.

6/25/12

I officially have 1 week left on the ship! It feels like it’s gone by so fast, but at times very slow. This experience so far has been AMAZING, but I miss my boyfriend, friends, and family and my big comfy bed! Anyways, I’m definitely going to make my last week on the USNS Mercy a week to remember!

Since I posted last, I’ve only got a few updates. However, some very interesting things have happened. With this being week 1 in the Philippines, we’ve had all new surgery patients and cases. With that being said, each day, two pharmacy staff members have the opportunity to go observe some surgeries. The day I went, I witnessed a routine hernia repair on an older man. The whole surgery took about an hour. We met the anesthesiologist and he explained to us that since he was elderly and actually had a cataract surgery planned for the following day, he didn’t want to completely anesthetize him. He received an epidural, benzos, and local anesthetic. During the surgery, he would open his eyes and kind of look around and it made me nervous! But the docs assured me that he couldn’t feel anything and wouldn’t remember anything afterwards. It was really funny because there were times during the surgery too when it would be dead silent and he would start snoring! The doctors joked that only an experienced anesthesiologist could do that.

Towards the end of the surgery, one of the nurses came in and asked me and the other student to come over to another OR because they had a tumor they wanted us to see. We both looked at each other, said cool!, and followed her over.  The patient was a 16-year-old girl with an ovarian cyst that made her look like she was 9 months pregnant. It was huge! They were at the point in the surgery where they had already cut down to the surface of the cyst. The next step was to drain some of the fluid inside of it so they could then remove the cyst much easier. They ended up draining 6 LITERS of brown fluid from the cyst!!! It was so disgusting but so awesome to see! After draining, they removed the rest of the cyst and it looked like a deflated basketball. The thing was humongous! The doctors were taking turns getting their picture with the cyst because they were so amazed by it’s size. As the were sewing her up, it hit me that this girl was a small, petite person who had been plagued with the burden of carrying this thing around for YEARS. It made it so clear to me that this mission is not only helping people with life-saving care, but changing the lives of those who couldn’t afford or didn’t have the means to do so themselves. This girl has such a bright future ahead of her and I’m anxious to see her recovery and reaction to her stomach size when she starts the healing process.

We were only in surgeries for 2 hours, but that 2 hours definitely changed everything this mission meant to me. It was a life-changing experience to witness those people.

Other than the surgeries, the days have been somewhat normal. I have been making more and more IVs and been enjoying every minute of it. One day, some of the Navy guys did a station exercise with practice problems set up around the room. There are about 8 students here and we took turns working through the problems and eventually went over the answers (it took us awhile since some of the questions were hard!). I really enjoyed this exercise because it made me more familiar with hospital pharmacy drugs and calculations. The guys here are great and most of them really enjoy working with us and showing us the ‘Navy way’ of doing things. Sometimes the ‘Navy way’ isn’t the most practical or most direct but it works for them here. Pharmacy operations are definitely different than the normal US practices, even though the government runs it. The software isn’t very new, there’s not a wide variety of meds, and you can’t just order something and it be here the next day, but the system works for the situation and is quite effective regardless. There are some glitches but it’s definitely been interesting to see their way of doing things.

That’s all I got for now! I go out for my MEDCAP on the 29^th and 30^th so I’ll definitely have some updates before we get to Subic Bay to disembark!!

DAY 4: 06/12/12

The windows were creaking, doors banging together viciously and the wind whistling through the small crevices in the wooding wall separating the classrooms. I had been startled out of my cot by the commotion resulting from the ferocious thunderstorm taking place at the early dawn at 0300. I got up, surveyed our immediate surroundings and when I was satisfied that everything was in order, I took some fever medication to mitigate the intensifying feverish conditions and went back to bed. I woke up again at 0530 and to my utter surprise saw a crowd waiting in the rain. This was the last day of clinic on the mission and evidently the locals were anxious to be seen as early as possible. We had our early morning muster as usual at 0700 and discussed a number of topics. Among those discussed was the fact that we will be working shorter hours that day because we were scheduled to leave early the following morning and therefore had to have enough daylight to wrap up our operations on the Island.  We were much more efficient on this day and delivered treatment to a lot of patients. We still had a lot of the medications we brought to the mission left and decided to be very generous by filling maintenance medications like lisinopril, hydrochlorothiazide for a 6-month supply instead of the 30 and 90-day supply we had been dispensing to the patients hitherto. We wrapped up operations for the day at 1400 and got together as a group for our afternoon huddle. We deliberated on the day’s activities and the mission as a whole. Our operations commander conveyed to us at this meeting that we had treated in excess of 500 patients that day. There was however a sizeable crowd still gathered outside who could not be seen and looked very disappointed and even agitated. It was decided at this meeting that we will distribute the remaining supplies and some nonprescription medications to the waiting crowd, to ensure that everybody that made an effort to attend our clinic will at least get some sort of care. The three clinics therefore gathered their remaining supplies of sunglasses, toothbrushes, toothpastes, dental floss and other like items. The pharmacy department also augmented this impressive collection with the remaining multivitamins, shampoos and some other nonprescription medications. We set up stations for the various supplies available and ushered the crowd through the stations from the entrance in an orderly fashion. This way the each patient moved from station to station picking up toothbrushes, sunglasses, vitamins and other supplies displayed and was ushered out of the camp after visiting the last station. It proved to be very efficient and key to ensuring that everybody was served in an orderly fashion. I was at the dental station demonstrating to the locals the use of the dental floss. The sight of me baring my teeth and flossing away elicited a chuckle or outright laughter from anyone who saw my demonstration.

                                                             Demonstrating flossing

The pharmacy team went back to the pharmacy, cleaned the place up and packed up the remaining medications. We then joined other members of the team to break down our tents, together with some other heavy gear we had on the site and transport them to the helicopter landing site for our departure early the next morning.


We enjoyed some delectable Indonesian cuisine for lunch at the Mayor's house. We got together with some of the locals who had still gathered at the camp after lunch, took pictures and played volleyball with them. We had become very attached to a number of the locals who lived on the school compound in the past three days. For dinner, the resident doctor treated us to a buffet of authentic Indonesian food. Among the food served was rice cooked in coconut juice, noodles and fried whole pork. We came back to our camp some few hours later to witness a long table lined up with even more food at the forecourt. A local church had decided to organize a farewell church service for us and had all brought food for us, as part of the service. There was a glut of food for us today! After a brief sermon, a speech from the Island’s mayor and another from our operation commander we were invited to sample the meals available. Most of us were too full to take another bite but nevertheless got up for some few scoops in order not to offend our hosts. We kept the fun going by singing songs with Ray, one of our interpreters displaying such dexterity on the guitar. I went to bed that night on a very full stomach thinking about the magical three days I had spent on this island and all the wonderful people I have encountered on this mission. I do not know whether we will cross paths again or whether I will ever be coming to this part of the world again but I do know that the memories and experiences I have attained on this mission will forever be etched on the tablets of my heart! 

Weekly Update 6/18/12

Sorry for not including very many pictures... Kofi has much more patience than I do!! Also, the internet out here has been AWFUL! This is my 4th attempt in 2 days for uploading this blog.

Since arriving back from my MEDCAP, the ship life has been somewhat quiet but definitely not dull!

One of the islands in which one of the MEDCAPs was stationed had an active volcano. From the ship I could see the smoke steadily streaming out. I found out that the volcano had actually erupted a few weeks ago but it was determined to be safe for the MEDCAP to go out still. The scene was still pretty incredible to see.

The first few days back on the ship, I was very appreciative of the things I missed. Hot showers, real toilets, and hot food were so spoiling! The only thing was that the ship was rocking bad. And after being on land for 6 days, I was not feeling so hot with all the swaying. I simmered down after about 2 days and then I adjusted back fine.

One night, the Captain came over the loud speaker saying all decks were closed due to inclement weather. This is unusual since the smoking deck is always open at-your-own-risk so I knew it must be bad. Of course, everyone in the pharmacy immediately jumped up and swarmed at the windows in the hall. The sky was completely gray and you couldn’t even see the water it was raining so hard. After the storm passed, it remained windy the rest of the night. Apparently during the night, one of the transport boats was severely damaged by the wind and being smashed into the Mercy. Also, the ramp used to get patients from the Mercy to the transport boats was destroyed and now sits at the bottom of the ocean. It remained very windy for the next few days and therefore all plans to leave for closing ceremonies were cancelled. Everyone getting off for flights as well as patients getting off after treatments, had to be lowered down to the transport boats by the life rafts. It was quite the ordeal for all the people to get off the boat. Helo ops were not an option due to the winds.

In our downtime for the rest of Indonesia, we watched movies and played games in the pharmacy pretty much all day. We did take some time to palletize the Philippine MEDCAP medications on some mornings.

Four of the girls I met when we got on in Guam left on the 14^th. I was sad to see them go since I started my journey here with them and wouldn’t be finishing it together. They were some pretty amazing people that I will definitely be friends with for a long time. And I’m glad I got to spend an amazing few weeks with such great people.

That Saturday, the 16^th, we got an official holiday routine! Finally, we got to sleep in since we didn’t have to muster until 0930 instead of the usual 0700. We even had abbreviated meal schedule since they served brunch. Some of the Project Hope people still here and I decided to rent a Wii and some games from MWR. We spent the day playing Mario and Just Dance, which was definitely a great break from everything. After dinner I brought the Wii down to pharmacy to store for the night but we actually ended up playing for hours! It was hilarious to see our Commander and all the Navy guys (and girls) to play Just Dance and actually be in to it. We had a great time with everyone and it was definitely nice to relax and hang out together.

As we began our 3-day journey to the Philippines, we received a news release warning us of a typhoon currently hammering the location we were headed to. As we got close to the Philippines, the weather picked up and it was extremely windy outside and therefore the ship was swaying bad.

On one of the days we were in transit, there was a ‘frocking’ ceremony held. This is a formal ceremony in which people eligible for promotions are pinned and recognized. There was one young man from our pharmacy department being promoted so we all went to support. It was pretty neat to see the official changing of ranks and formal dress of the ‘frockies.’

There was also a birthday celebration one afternoon during transit. The Army turned 237 years old! They made a huge cake and celebrated all the Army personnel on board. It was pretty cool seeing all branches of the military hang out together and celebrating.

After leaving Indonesia, some people started getting sick. As it became more prevalent, officials determined we had Viral Gastroenteritis spreading on the ship. As of yesterday, at least 30 people have been quarantined on one of the wards to prevent further spreading, if possible. Preventative Medicine also decided to remove all self-service food items from the Mess Decks since they thought that might be a possible source of the virus. So no salad, no fresh cut fruit, and any sandwich bread has already been pre-saran-wrapped to prevent hands touching everything. It’s been weird at meal-time since our options are so limited now. So far, 2 people in the pharmacy department have come down with the virus and are in isolation down in one of the Wards with the other contaminees.

Yesterday, the USNS Richard E. Byrd came up next to us for a few hours to refuel us and restock some of our supplies. It was an amazing sight to see! The helicopter was lifting pallets of supplies off the ship and dropping them off on the Mercy while they refueled. The whole process took hours but was very cool to watch. Kofi and I stood on the outer deck for awhile talking to one of the Navy guys about how the whole process works and some facts about the ship. He was very friendly and helpful.

Well, that’s all I have for an update!  Hopefully I’ll update you all again soon now that we’re in the Philippines.

DAY 3: 06/11/12

I was up and ready for the day at 0530 today. I had already had one full day of work on the mission under my belt and knew what to expect. I was invigorated by our exploits as a team the previous day and was stoked and ready to work harder to achieve better results today. I had no doubt in my mind that we will do better in terms of the number of patients we take care of and our quality of delivery. We were better acquainted with our formulary: what is on it, where they can be located and their major counseling points. We knew the major drugs prescribed by the providers present on the mission and the most prevalent disease states and conditions presented on the mission. A cursory look outside the perimeter of our camp revealed that the locals had already converged outside the camp waiting to be seen. It was a bigger crowd than I witnessed in the early morning of the previous day. I did also see some buses parked where the locals had gathered. I found out later from the resident doctor that those buses had actually transported patients from neighboring villages to our clinic. I knew it was going to be a hectic day, but I also knew that this indefatigable and resourceful team of ours was up to the task. I was ready to go!

We, as usual had our morning muster at 0700, after we had had some breakfast. It was suggested at this morning’s muster by one of the providers that the pharmacy provide the three clinics with some of the medications popularly prescribed by them to be given to the patients after they are seen, in an effort to take some of the load off the pharmacy department. This was accessed by our Pharmacist to be a good idea since a majority of the medications requested did not require extensive counseling. Ibuprofen, the NSAID of choice for most of the providers, particularly the Dental Clinic, adult and pediatric multivitamins and albendazole were some of the medications approved. This proved to be very efficient in treating and dispatching the numerous teeth extraction patients who were only prescribed painkillers and other patients whose conditions only warranted uncomplicated regimen. It really did help to relieve some pressure off our department, considering the size of the crowd today.

We were however still inundated with prescription to be filled. I was however actually enjoying the busy work. I felt more confident about my counseling skills, I could locate the medications on the prescriptions with little effort and we had developed a more efficient way of reconstituting our drugs. We had also established good rapport with our interpreters and were in sync with them. I had gotten to know more about the culture of the locals and could relate with them better. Everything was working seamlessly well and nothing was going to slow us down! The whole mission had seen 670 patients when we shut down operations at 1530. It was a very productive day for us and it was all made possible by virtue of our astounding teamwork.

                                               The wonderful team at the Pharmacy

A couple of the team members and the interpreters found it fitting to head to the beach and cool off after the evening’s muster. We took the opportunity to see more of the village on our way to the beach and fraternize with the locals. I volunteered the customary greeting of “salamat sorre” to every local I encountered. They always responded to my greetings with giggles and an obvious sense of amusement. They still loved us and trooped out of their houses to catch a glimpse and greet us! Sitting in front of one of those house with his mother and screaming “Mister, Mister” was this adorable and playful little kid. I went over to acknowledge him and say hello. I unleashed the Indonesian phrase of the day I had learnt from our interpreters: “Nama saya Kofi” and then pointed to the kid to say, “my name is Kofi, what is yours?” The mother instantly replied “Obama”. I asked: Obama? The mother nodded in agreement and I instinctively whipped up my camera! I just had to get a picture of Obama, with the consent of the mother!

                                                                     Obama

The beach had an awesome and scenic backdrop with sprawling, peaceful mountains, green and lush vegetation. A lot of the locals were already there at sunset to take a swim. Some had also followed us there. It was a breathtaking and welcoming environment with kids running around playfully with no care in the world. The water was calm, inviting and full of revelers. I would not be left out of the fun so I wasted no time diving in and having a swim. The cool water was just the escape I needed from the sweltering heat. I had a wonderful time carry kids on my shoulders as they jump into the rushing waves and also taking pictures with all the locals who requested them. We came back to the camp, cleaned up and honored the invitation by the wife of the Mayor to her home for dinner. Dinner was noodles cooked in spicy vegetable soup, just what I needed to fight off the cold I felt coming on then. I went to bed that night feeling a bit feverish and had to take some medication.....

                                                                   At the beach
 

MEDCAP 2: Day 6

I was up and moving by 0415. I quickly got dressed and started packing up my cot and mosquito net. Everyone was bustling around to get everything packed up. I had just gone to the bathroom for what I hoped was the last time there when I heard the helo. I got SO excited to know we were being saved! It dawned on me to check my watch and it was only 0530 so I knew something was up. Sure enough, word at muster 15 min later was that the helo had only dropped some nets and logistic men and wouldn’t be returning until the afternoon after placing MEDAP 5 (Kofi). So we weren’t saved yet…

After hearing that news, I was crabby and smelly (no real shower for going on 6 days) and tired. We finished cleaning up the school area and walked over to the helo site. After about 30 minutes the OIC decided we would just hang out back at the school for a few hours so we would be out of the sun. He also gave us liberty but made it clear that if you heard the helos you betting be running because they weren’t going to wait for anyone. We went back to the school and sat on the steps again for about an hour before a group of 4 of us decided to take one last walk down to the market. So we walked and talked for the ½ mile journey. It was me, Flying Officer Warren (Sam), 2^nd OIC Moreno-Chow, and the Dental Hygenist Shannon. As soon as we got there, I went straight to the store with the cold drinks a bought an ice cold soda. It was SO refreshing, I could feel my bad mood melting away. We just so happened to walk by the beach just as our translators were leaving by boat. We frantically waved and wished them well. We walked around and bought some snacks and such before heading up the hill back to the school. When we got back, we sat and chatted for about an hour before I finally laid back on the tile and fell asleep. I woke up a while later very stiff and uncomfortable, but feeling quite refreshed. However, my uncomfortable nap quickly left my memory when a local woman brought over a whole container of fresh, fried bananas. I cannot even describe how AMAZING fried bananas are. I was definitely in heaven. I ate 2 and would have had more if they weren’t so filling. We began to chat again as a thunderstorm rolled in. The rain didn’t stop the guys from playing basketball with the kids though. I couldn’t help but think to myself that the storm was delaying our departure. I was beyond ready for a shower! We mustered again around 1200 to get our stick assignments for the helo ride back before walking back over to the field. Thank the Lord I was on stick #1!! That meant a shower sooner than later! So we walked back up to the field where by now all the bleachers and areas surrounding were filled with people watching and waiting. We waited for what seemed like eternity with people constantly asking us for photos. I was so disgusting, I can’t imagine why they would want a picture of me. Some people would even just walk up, not say anything, snap a photo, and then just walk away.

Finally, around 1300, the helo came and got the COMS guys going to the next MEDCAP. About 15 min later, another helo came for stick 1 (me!) and we left as quickly as we arrived. The first thing I did when returning to the ship was shower, of course. I then threw on some PT gear since that was the only clean clothes I had.  I immediately threw the nasty clothes I was wearing in the wash. We had to muster 1 last time as a group once all the people were back and I refused to wear those clothes without cleaning them. It felt soooo good to be back on the ship and get clean. My gear didn’t get back until later that evening so I had to wait to do all my laundry with everyone else getting back that night. I was so exhausted by the time I went to bed I couldn’t fall asleep. My thoughts were cycling over the experiences from the past 6 days as I finally closed my eyes in my own bed. 

MEDCAP 2: Day 5

We got up at 0530 for 0630 muster to start seeing patients at 0700. Before we mustered, I sat on the steps while Sam and I shared one of the avocadoes we received last night. It was perfectly ripe and fresh and creamy! As I sat there trying to enjoy my breakfast, I couldn’t help but notice that I was already sweating profusely and I knew then that it would be a long day. However, shortly after muster, our interpreters arrived with lots of yummy snacks and it made me smile at their kindness. We have definitely been blessed with some amazing translators. They brought cakes, cookies, more mini bananas, banana chips, and “mocktails.” It definitely brightened my day!

We immediately starting to get patients flowing through and our last treatment day began. I got a lunch break around 1130 for about 40 minutes. Otherwise, we went straight through from 0700-1900. There was a point around 1500 when we had to stop filling prescriptions and do a full inventory of our remaining supplies per the OIC (Officer In Charge). We were closed for about 30 minutes. By the time we were back up and running, we had a room full of people waiting and a large stack of prescriptions waiting to be filled. It was like this for the rest of the day! Dental had stopped taking patients around 1100 due to lack of lidocaine needed to perform procedures and sent some people over to help us out. We got a volunteer to help us fill and once we got an extra person, things seemed to flow much better.  Dr. Bemiller even came over after seeing her last patient to help us finish up. It was definitely a group effort and I’m so lucky to have had the chance to work with such amazing people. Without a group effort, the day could have possibly ended pretty miserably. After we finished filling our last prescription, I went and sat on the steps outside of the pharmacy, as usual, to reflect upon the day.  And again, there were some of our troops playing basketball with the kids. It amazed me that no matter how hot or how long of a day we had, they would still play with them.

As patients slowly filtered out, equipment and more people came in. They began to set up speakers for our piesta (festival)! As we sat and watched, our interpreters brought out the ‘mocktails’ and we sat there together reflecting on the week and playing some games. The drink was of course non-alcoholic and made with young papaya and juice. As the crowd grew, the local officials began a ceremony with out OICs in which they exchanged kind words and gifts. When they were finished, they invited everyone to dance. It took a few minutes until the local governor took initiative and started a congo line in which he, as the leader, would start a dance move that everyone else had to copy. It was pretty hilarious since us Americans are so tall compared to most of the Indonesians. I sat and watched everyone just taking it all in. About half-way thought the dance, a young man came up to me and asked why I wasn’t dancing. He may have asked me to dance as well but I wasn’t sure since his English wasn’t very clear. I told him politely that I was perfectly content to watch and dancing wasn’t my thing. He sat down next to me and we sat in silence watching everyone else. Slowly people began to leave the dance area as the music transitioned to a new song. The young man excused himself to catch up to one of his buddies. About 20 minutes later the music stopped, people starting leaving, and we began to clean. As I got up to get my things together and get ready for bed, one of the translators stopped me and another girl on the MEDCAP explaining that these 2 young men wanted to trade mementos. We both stood there slightly taken off guard, frantically trying to think of something to give them. The interpreter said even an American dollar would be cool to give them and I thought, prefect! So I went to get my wallet and met back with my friend, the 2 guys, and the translator a few minutes later. The first guy handed my friend a glow-in-the-dark beaded rosary which was really cool! The guy I traded with gave me a heavy metal necklace with his name engraved on the dog tag. I told the interpreter that I couldn’t accept this gift! He relayed the message to the young man and he was insistent that I keep it as a memento and thanking me for the American dollar. I was extremely flattered and shocked that he was so willing to give such a personal item to me for just $1! We said our goodbyes and took a picture since it was already 2200. We mustered shortly after that and were told to be up by 0415 to start packing up our gear since the helos would be arriving around 0600. I therefore hit the rack immediately after the meeting.

DAY 2: 06/10/12

I was woken up today by the sound of roosters crowing in the early morning at 0510. The tiring activities of the previous day made for a sound sleep even in this hot and musty weather. I woke up feeling refreshed and ready to take care of some patients. I took a peek out of the opened windows of this classroom that was our dormitory to get a feel of the fresh morning breeze and to my utter surprise saw numerous silhouettes dotted in the darkness of the early morning. The locals had already started gathering outside the perimeter of our camp, waiting to be seen! Our clinic was scheduled to begin at 0800 and gathered here at 0510 were these committed and resilient people eager to take full advantage of the vast array of health services we were about to offer them free of charge. I freshened up, got some breakfast and got ready for the morning muster at 0700. We converged at the forecourt of our camp promptly at 0700, had the morning muster to ensure that all 59 military personnel and volunteers on the team were accounted for. We then deliberated on the form our workflow for the clinic will take. It was decided that patients at the entrance of the perimeter would wear color-coded bands before they are allowed passage into the perimeter. The red, orange and green bands would be used to identify patients getting services from our three main clinics: General medical care, Optometry and Dental care. Once banded, the patients would proceed to a patient admission desk placed close to the perimeter’s entrance where patients’ information will be collected, SOAP notes formulated and vital statistics taken, if needed. The patient would then be directed to the appropriate clinic they would need care from. After receiving care, the patients would head to the Pharmacy to receive their medications and the concomitant counseling points for those medications. The patient will then be ushered to the discharge desk, the last point of care right by the Pharmacy, have his band taken off and then directed out of the perimeter. We also had a makeshift laboratory set up in one of the classrooms for basic lab works like glucose checks etc. This workflow proved very efficient in ensuring that the crowd was controlled and patients were seen in an orderly fashion. The crowd had blown up into hundreds of people by the time we completed our morning huddle. After a meeting of our Operations Commander with some community leaders, it was communicated to us that the locals had made a request for us to start the day with a brief church service since it was a Sunday, a church day for the community. We readily obliged to their request and after about forty minutes of a fun service which included a sermon in Indonesian, a rendition of  “Amazing Grace” performed by us, the team and a customary offering, we started seeing patients at 0900.

                                    Locals gathering early in the morning

    

The Pharmacy was spared the initial hustle and bustle that was evident in other departments of our mission during the first few minutes the clinics were opened but began to see an influx of patients who had already received care from the various clinics at about 0930. This was a sign of how busy we will be the whole day. Unlike the three clinics, the Pharmacy had to see virtually all the patients who entered the perimeter. They had to get their prescriptions filled by us regardless of the clinic they sought care from! Thanks to the good teamwork of the Navy Pharmacist, the Navy Pharmacy Technician, our three Indonesian interpreters, and myself we were able to keep the line in check, giving the patients their medications with the appropriate counseling and getting them on their way in an average time of about four minutes. The fact that our three interpreters had prior counseling experience with MEDCAP 2 was a tremendous factor in ensuring that they had an idea of the messages we were trying to convey to the patients, resulting in efficient and effective counseling sessions with the patients. I instantly picked the Indonesian phrase for the first question we required them to ask all the patients in regards to whether they had any drug allergies; “Allergy oba?” and took the liberty to ask the patients when I had to wait for an available interpreter. It got so busy at that pharmacy that we barely had time for lunch. We had decided as a team to shut down operations at 1230 for lunch but the pharmacy still had patients trickling in after 1230 because we had to get their prescriptions from the various providers the few remaining patients had seen prior to the shutdown filled before we could take our lunch. We saw the last patient before the shutdown at about 1250 and therefore had to be content with a 15-minute lunch before the first patient for the afternoon session walked in. The afternoon session went pretty much like the morning session with a steady traffic of patients. The last patient for the day walked out of the pharmacy at about 1545.

The whole mission saw about 480 patients on the first day. The majority of medications dispensed on the day by the pharmacy were pain medications. The Dentists at the Dental Clinic performed a little more than a hundred tooth extractions only in the first day, hence the high number of prescriptions for pain medications. We also received an appreciable number of hydrocortisone, bacitracin and neomycin prescriptions for various dermatological conditions. The Optometry Clinic also wrote a lot of prescriptions for artificial tears on this day. It was a grueling day filled with brisk commuting to and from our pile of medications lined against the walls of this classroom, reconstitution of medications and nonstop verbal and physical communication. The sheer number of patients we were seeing and the realization of the tangible difference we were making in the lives of these lovely people was however the boost I needed to ensure that I felt no sense of fatigue whatsoever all through the day. We got together again as a team in the evening to reflect on our performance for the days and to fine-tune it for a better performance the next day. I had an MRE dinner of roast beef, took a bath with water drawn from the well and retired to bed early, knowing too well what awaits me the next day…….

MEDCAP 2: Day 4

I actually slept pretty good last night for the first time since being here. When I say 'good,' I mean that I only woke up a few times instead of every 30 minutes. We started bright and early, mustering at 0700 to start seeing patients at 0730. It was busy all day from the beginning and HOT. I definitely sweat all day and had to take a few water breaks throughout since I started feeling over-heated. I did have the opportunity to counsel patients on information Sam had me look up. It was a great refresher for some of those meds I haven't seen in awhile. It was a heart-warming experience to be able to educate the people and inform them some possible side effects as well as counseling points they should be aware of. This way, they can better understand the medication and not be alarmed when something happens.
The interpreters brought us some fresh fruit in the morning so I spent most of the day trying some amazing fruit. Some of it I really liked and some things I really didn't. The local people hosting us, specifically the governors's wife, made us shrimp fried rice for lunch. Although I'm not a fan of shrimp or rice, I tried it and it was pretty good since it was so fresh. Our interpreters also brought us sweet buns and banana chips. Both which were A-MAZING! At the end of a long, hot day, we finally got to sit down and relax in the slight breeze that there was. As we sat on the steps in front of the pharmacy once again, I realized everyone was in the middle of the school compound playing. There was a basketball game going on in the middle, frisbee on one side, and volleyball on the other. All the kids were participating too. It was a beautiful evening once we stopped running around and had the chance to sit and catch our breath.
We had a good half hour break before muster where we were told we could have liberty for 2 hours that night in groups of no less than 5.Sam immediately told us to go change as she went to talk to the chief. She got permission for us to go to the local pharmacist's house to meet her family as well as the Governor's house where our interpreters were staying. I was really excited to see what the locals call home. We ended up having quite a large group come with us. When we got to the house, they had a whole spread of for for us and insisted that we grab a plate and enjoy. I was again shocked by their kindness and generosity. The food I had was delicious, of course, and I ate everything on my plate. I did avoid the meat knowing that they typically eat dog. After socializing over our meal, we went over to Yvonne's home (the local pharmacist) to meet her family. They were so gracious that we came by! They invited us in and offered us some fresh fruit and avocados. The fruit was amazing and SO yummy! And the avacado we took to eat later. We couldn't stay long since we had to be back for muster. We apologized for our short visit, said thanks for their kind gifts, and said our goodbyes before heading back to camp for the night. That evening at muster we found out that our last day would be a full day instead of a half but Commander said he knew we were a great group and could push through still giving quality care. He was definitely a great motivator for us. Since we knew it would be a long day, we decided to pack it in early for the night and get some sleep!

Hello! Greetings from the lovely people of Essang, Talaud in North Sulewesi. I know I have been missing in action for a while. I was a medical mission with my MEDCAP as scheduled for 5 days. I am back on the ship with a plethora of stories and life-changing experiences that I hope to serialize and share with you in the next couple of days. At the risk of sounding trite I will once again go ahead and state that this mission have been magical, a thrill ride and a trip of a lifetime! Every week I have spent on this mission seems bring me experiences and stories that surpass the previous week's experience! I have heard stories, been touched by people and had experiences in the last three weeks that many people do not have the privilege of experiencing in their lifetime!   

DAY 1: 06/09/12

I woke up on this day at 0330 anxious and giddy about the mission we were about to embark on. I was a team member of the last MEDCAP on this mission in Indonesia visiting the remote Island of Essang, Talaud. Being that remote, it was decided that the most reliable way to get us there was by a helicopter. We therefore mustered and gathered as a team at 0445 in the early morning for a helo (helicopter) safety brief. This being my first ride on a helicopter, the safety brief did not help in calming my nerves as it mainly centered on what to do in case the helicopter crashed. I am however positive these are life-saving information we needed to know in case the unthinkable happened. We were then dismissed for breakfast and instructed to reconvene by the helicopter pad at 0645 for the beginning of the flight-ops (flight operations). We were transported in batches of eight with me being on the third batch of personnel to get on the helicopter. At 0730 we were fitted with safety helmets, goggles, floatation devices and ushered to the helicopter pad where got on the helicopter in the midst of ferocious winds from the blades of the helicopter. Once airborne, my anxiety evaporated and was replaced by pure euphoria at the beautiful spectacle of the calm blue sea, gently caressing this huge ship and the lush, green Islands that appeared on the horizon. The view from up there coupled with fresh breeze emanating from the opened doors of the helicopter made the ride magical and awe-inspiring. We landed after about 15 minutes in the air on a swampy field and were greeted by hundreds of cheering locals lined around this field who will not be deterred by the flying leaves and debris as a result of the ferocious winds churned out but the helicopter. Obviously our presence was a huge deal for them! They had never had a helicopter land on their Island and this was a show everybody out there wanted to see!

Essang, one of the Islands of Talaud in the North Sulawesi province of Indonesia is a small remote Island with a population of about 2000 people. It is mostly swampy with a green vegetation. Unlike residents in most parts of Indonesia who are Muslims, majority of the indigenes of North Sulawesi are practicing Christians. The people were very nice, welcoming and hugely appreciative of our presence. They gave us the royal treatment, with their main road adorned with flags and village folks cheering us and singing songs as we proceeded from the helicopter landing area to our mission’s base on the Island’s elementary school. The mayor of the Island, the resident doctor of the Island’s clinic, some medical personnel from the Island and other dignitaries met us at our base. We exchanged pleasantries and mingled with the locals who had gathered to greet us and acceded to numerous requests for photo-ops from the locals with their cell phones, which is turning out to be a constant fixture in the whole mission. There is always the constant refrain of “Mister, poto?” whenever we are with the people on this mission! We got together after all the team members, together with our gears and supplies were airlifted from the ship to our base on the Island and after a muster and a brief meeting begun the arduous tasking of setting up camp. We made a dumpster from the pallets that carried our supplies and put up some tents that would serve as our bathrooms. Those bathrooms were however not an option for me as the tents sat too low and the whole process involved in taking a bath in there and attending to natures call was too cumbersome for me to consider. The sweltering atmosphere that prevailed in these tents also contributed to its lack of appeal to the majority of the personnel on this mission. We then set up our sleeping cots with mosquito nets in one of the classrooms that housed our medications for the mission. This classroom also served as the pharmacy for the mission during the day. 

We were introduced to our Indonesian interpreters: Ray, Patrice and Mea when they got to the camp in the late afternoon. They were of immense help and taught us about the culture and some few Indonesian phrases. My favorite phrase to the patients was “segera sembuh“, meaning get well soon. It never failed to elicit smiles on the faces on the patients whenever I said that to them! I was drenched in sweat and was badly in need of a shower after we completed setting up camp and the pharmacy. I therefore contacted some of the locals living nearby, with the help of our interpreters about taking a bath in their bathroom. They readily obliged to this request to use their bathroom. The bathroom I was ushered to was a small tiled cubicle with a porcelain-decorated hole dug on the floor farther by the side. This hole served as the toilet. This space essentially serves a dual role of a shower cabinet and a toilet. There was neither a pipe nor a shower in this bathroom. They showed me a well nearby and offered to draw water from this well for my bath. Due to my eagerness to experience things for myself and not be treated like a royal, I insisted on drawing the water myself. It was tricky at first and the locals got a kick out of my initial struggles but I got the hang of it after a few tries. I drew my bucket of water and got my much-needed bath. We then got together as a team to have lunch, the ubiquitous MRE (Meals Ready to Eat), reflect on our progress and plan for the days ahead. We were dismissed after lunch to do a little bit of sightseeing, rest and prepare for the next day. In the evening, we feasted on a buffet of Indonesian cuisine prepared by a local family who were gracious enough to invite the whole team to their home for dinner. That was a really good dinner; I have fallen in love with Indonesian food! I went to bed early in the evening in my tiny sleeping cot nestled in the hot and humid classroom with the rather noisy chirping of the numerous crickets to boot but fully happy and content with the obvious ecstasy that our mission and presence have brought to these nice people…..

MEDCAP 2: Day 3

Today was an excruciatingly humid day. It wasn't even that hot out but the humidity was intense! The pharmacy was busy today and constant vs. yesterday's splotchy chaos. That's more of what we expected though so it wasn't terrible. We dispensed over 400 prescriptions and had fun with our interpreters in the process. We saw many people with hypertension, VERY bad hypertension. The dentists and opthamologists refused to see patients with BP >150/100 since most of their problems were caused by there high blood pressure. Some patients were treated immediately and asked to wait for 30 min to be reevaluted. Most patients could then be seen after their BP came down. My MRE lunch today was pretty terrible. I'm actually looking forward to ship food...
Tonight as we were finishing up, we were called to an emergency muster. We were told that some buses had been arranged for us to go to the beach in 15 min! I was SO excited even though I didn't bring any swimming attire. But I quickly changed into PT gear, ran to sign the liberty sheet, and was on the first bus to the beach. We even got a police escort for the 6km trek to the shore. It was so beautiful, remote, and serene.

 I didn't want to get in at first but everyone but a few were in the water within minutes. I got in for about 5 minutes total and I'm so glad I did because it was quite refreshing. One girl actually got stung by a jelly fish so I'm thankful I didn't stay in too long! Our interpreters came too so we took lots of pictures and had some laughs. All the locals came down to the beach to watch us as if we were celebrities. The interpreters said everyone is just so fascinated by us and appreciative that they ust want to be around us. It's very flattering that they all love us being here. As we returned to the school grounds, the children were so excited we were back to play basketball with them.
Slowly people began to gather around the pharmacy steps with a guitar and started singing songs. We stayed there for almost 2 hours! It reminded me of some summer nights in NH when we sang around the campfire. We also got the Indonesians (including the kids) to sing their national anthem. It was really cool to hear the whole thing. I was sitting here just trying to take it all in knowing these are some amazing memories I'm making. we mustered briefly before heading to bed. One more full day of treating patients before a half day on Friday before our departure on Saturday. (Little did I know that Friday would actually be our longest day here...)

MEDCAP 2: Day 2

This morning was HOT! I immediately started sweating when I got up and moved around. It's really not even that hot just extremely humid. We ate breakfast, met as a group to discuss points from yesterday & the POD (plan of the day), and got the pharmacy prepared for the day. When our interpreters arrived, Ray gave me a 'cheat sheet' of common phrases we probably had him say a million times yesterday. So hopefully by the time we leave, I will have al the basics of Indonesian pharmacy terms down!
It was a long, hot day in the pharmacy. I didn't stop sweating until the sun went down. I did learn some main counseling points for certain antibiotics which was a good review, and got to see more patients. We definitely had way more chronic disease and acute illness patients today than yesterday so I feel much better about being able to help people. As we wound down for the evening, we were told that we could leave for liberty for a few hours! So we got the opportunity to walk down to the markets nearby. It was quite the experience. As we were walking, people drove by on mopeds waving or came out of their homes to say hello. Once we got down town, people immediately came up to us to shake our hands and take pictures. It's a weird feeling knowing we are a spectacle to them. We brought a few of our interpreters to help guide us and talk to the shop owners and what not. The place was busy and bustling with town folk who run the market as well as people who had followed us down as we walked past their homes. We browsed some shops for awhile before deciding to walk back to the school compound. On the way back, the children walked with us singing songs, holding our hands, and telling us Indonesian words. The people here are so welcoming and appreciative of our presence. When we got back to the school, the security guards were singing karaoke! Some of the Navy guys were playing 5v5 basketball with the kids. It was really cool to witness everyone hanging out together, playing, and having a good time. We went to bed shortly after evening muster since we were all tired from the poor night's sleep the night before. I still didn't sleep well since I was so hot. However, what sleep I did get was rudely interrupted by a morning thunderstorm. As I lay in bed listening to the rain on the tin roof and enjoying the cool breeze, I suddenly realized this would be a perfect time to get a shower and soap up. So I got out of bed and thoroughly enjoyed a cool morning shower at 0530 to start my day. (Little did I know, this would be the only shower I got on this excursion...)

MEDCAP 2: Day 1

Today started very early and was quite eventful! I mustered at 0530 and then proceeded to the flight deck for our helo safety brief. I got  my flight assignment and grabbed some breakfast before returning to the flight deck to prepare for lift-off. It was very cool to see the ship from the air and some of the islands of Talaud, Indonesia. The water was a turquoise blue and the mountains were full of jungle thrush and very steep! When we landed, we were immediately greeted by an Indonesian military member. As I started to look around, I noticed that the entire landing field was surrounded by town-folk watching us. As we walked down the road to the school where we would be staying, people were lined up all the way down the road saying 'hi' and trying to shake our hands. It was like we were celebrities or something! Once we got to the school compound, it started to rain. We sat and waited for the helos to return with our 12 pallets of supplies. We then unloaded all our gear and set up the pharmacy. Before we started seeing patients, we ate lunch and I had my first MRE (meal, ready-to-eat). I must say it wasn't too bad but I can see how they would get old very quick! We started seeing patients at 1300. We were sent 3 translators to help us communicate the medication directions and counseling points to the patients. We got to know them pretty well already and they are fun, kind, and personable people!
The local people here are so appreciative of our assistance. It has already been a humbling experience since most of the patients are very sick and what we would think to be a standard treatment in America is actually an impossibility here. Most people were under the impression that this mission was a 'SURGCAP,' meaning we would be screening patients and doing surgeries. It was quite depressing at times when patients would bring us their paperwork and prescriptions and the cheif complaint note was 'lump in L breast x5 years & lump in L lymph x2 years' with just a prescription for Tylenol or Motrin. We definitely don't have the capabilites to treat cancer on this mission since it requires such extensive follow up. Some of the cancer cases were very gruesome and it was difficult to see these terminal patients in such pain and discomfort. It was hard to explain to these patients that even in the US, we wouldn't be able to treat them since their condition was so far along already.
I know being here does help most of the people we see but it's heart-breaking to be unable to help some of the severe patients. After we shut down for the evening, some of the Navy guys had the opportunity to play basketball with some of the kids. It was nice to hear some sincere laughter after such a long day. As we got ready for bed, the decision was made to have us (Flying Officer Warren, HM2 Rodriguez, and myself) to sleep in the pharmacy. Since it was unable to be locked and some windows were missing completely, we decided that staying here would possibly deter unwanted visitors.

Before bed, I had the lovely experience of having to pee in a bag for the first time. This is the toilet system we will be using for the next few days. The Navy provided us these disposable bags with some kind of absorbable material to reduce the smell. It was also realized tonight that the shower bags were forgotten so we most likely won't be showering for 5 days since the ship is already 250+ miles away. Thankfully we have tons of cleansing wipes which will have to do!
That first night of sleep was actually not too bad although my anxiety kept me from falling asleep right away and the uncomfortable cot caused me to wake up every time I rolled over. They were also small so I couldn't stretch out all the was especially since the mosquito nets were the most restricting part. OVerall, the slight breeze through the windows with the sound of the geckos, bats, and cicadas made it reminiscent of my childhood camping memories.
I was woken up by the light around 0530 but dozed until 0615. I then got up and proceeded to prepare for the second day!

June 3, 2012

Sorry this is another old one, but I wanted to go in order! I'll post my MEDCAP experiences soon :)

June 3, 2012

Tonight is my last night on the ship before departing for my MEDCAP on the southern most island of Talaud, Indonesia. I asked around and finally figured out what MEDCAP stands for: Medical Civil Assistance Program.  The location will be at a school on the island and the patients will be treated from 0800 to 1600/1700 daily. I am required to meet up on the flight deck at 0520 for a ‘helo safety brief’ at 0530.  That means I’m definitely getting a helicopter ride to the MEDCAP location!  We were shown the cots we will be sleeping on and the ‘bathrooms’ we will be using.  Word is that when the locals found out about our visit, they immediately offered to house the volunteers during the mission so I know they are excited about us being there and are very kind people. I’m really looking forward to all the new experiences coming in the next few days!

Since I last posted, we have received and very quickly organized the medications for the Indonesian MEDCAPS. It was a crazy couple of days trying to get everything together. The main problem was that some of the medications in Indonesia are different from US drugs in strength, ingredients, and packaging. It was frustrating at times but our team is a very hard-working crew and we all work together quite well.  There are definitely some fun characters in our department so it’s been a good time throughout the process.

There have been a few days when I miss home and know for sure that military life is not for me.  The adventure of my upcoming MEDCAP has kept me busy and my mind off home! There is plenty of support available within my department, berthing area, and onboard that no matter what situation may arise, there’s always someone to talk to.  I do wish that the internet was more reliable so that I could talk to my friends and family more often but the break from technology has also been nice since I know I rely on it too much sometimes.

The other evening, one of the pharmacy techs took the initiative to teach me about the IV hoods they have on board. It was definitely a new experience since they do not have a sterile room but just the hoods with the big gloves to put your arms in.  I haven’t used that kind before so it was pretty neat to make an IV in the middle of the ocean! He also showed me how to check prescriptions just like a pharmacist would and how to double check calculations done by the tech before an Rx is sent out.  The hardest part was adjusting to the format of the orders and how the computer prints out the prescription label. I’m sure with more practice, I would get used to it very quick. I also had the opportunity to look up some information for a doctor on Thyroid Storm.  Thankfully the patient didn’t actually have this condition since the meds (PTU and methimazole) are not available on board to treat for it. The physician was just checking incase there was a complication during surgery causing the severe disorder.  I’m not sure if the doc went through with the procedure knowing that the medications needed to treat it were not available.

Well that’s it for now, I’m off to finish packing and go to bed since I have an early morning and a big day tomorrow! Hopefully I’ll be able to blog every day about my experiences on the Island!

Salamat Pagi! That is Indonesian for Good morning. I have made it a point to at least learn how to greet in the languages of the countries we visit. They love the effort to speak their language! The past 2 days has been two of my best days in life! I have witnessed the warmth, hospitality and the gratitude of the people of Indonesia. I have also been convinced of one fact; we are all the same people with the same needs, whoever were are and wherever we are on the face of this planet! We all have a need for acceptance, a need for respect and are capable of bringing pure joy and happiness in the lives and faces of anyone regardless of language or geographical barriers.

My awesome adventure began on the morning of 4^th June 2012 when I got a ride on a rib boat to one of the Islands in Talaud as part of a delegation from the ship to embark on some community relations on the Island. It was really a thrill of a ride! My sunglasses literally flew off my face into the sea. That was how fast the boat was! We were greeted ashore by the locals with pump and pageantry. We felt very welcomed! We began interacting with the people as best as we can, after the exchange of pleasantries and that was when my hitherto unrecognized celebrity status was discovered. Every one of the locals wanted a photo-op with me! I had mothers handing me their babies in order to have a picture of their babies and me! Apparently they have this fascination with my height! They thought I was Shaq or something. My incessant salutation of Salamat Pagi to everyone I met in no small measure also contributed to the reception I got from them.

We proceeded to a high school soccer field and got ourselves into a soccer match with the high school soccer team. The sweltering heat coupled with the awesome stamina of these kids contributed to me being out of breath and worn out after only five minutes in the game. Though my stamina was suspect, my skills were never in doubt! Suffice it to say that we lost the game to these youthful, exuberant kids after about an hour of a fun-filled game of soccer. Other members of the team also played volleyball with some of the school kids. After the soccer game we indulged the children with a game of duck, duck, goose. They took to the game so much that they were still playing it when we got on our bus. I also took the opportunity to engage in some interesting conversations about a host of issues with the few locals who could speaks a little bit of English. I thoroughly enjoyed spending time with the people on the Island and can still envisage the beautiful faces beaming with smiles and affections as we said goodbye.

I again had the opportunity yesterday to be part of a 30-member delegation that graced the opening ceremony of our humanitarian mission on another Island. We were transported on the rib boat again and this time around I made sure everything on my person was bolted down. I however couldn’t prevent myself from being splattered with seawater, as was the case in my previous ride. As usual, it was an exciting ride! We were again met ashore with a very colorful cultural display. While waiting for the dignitaries who had gone to the hospital ship for a tour, the locals again used the opportunity to have pictures taken with us. I was again treated like a celebrity on this Island with most of the locals looking for the opportunity to have their pictures taken with me. I did enjoy the attention but most importantly I did enjoy the pure and palpable joy that our presence here has brought these awesome and resourceful people. After about a forty-five minute wait, the dignitaries came back from the ship and the ceremony began. It was a short ceremony that commenced with a word of prayer and ended with some brief remarks from Captain Morgan (yeah I know, that name sounds familiar), the command of our ship, a Politician from the Island and another Captain from our ship. We were then treated to some sumptuous Indonesian cuisine and some local music. 

My interactions with the locals this week was a very rewarding and enlightening one. I look forward to being with them on my MEDCAP next week. The rest of the week is predicted to be relatively uneventful since we are pretty much caught up with the processing of medications for the various MEDCAPS. I also do not have any more events planned for the rest of the week. I promise to keep you all updated on this awesome adventure I am currently part of. Terima Kasih! (Thank you)

Tuesday, May 29, 2012

Sorry I haven't posted in so long! I've been writing but unlike Kofi, my internet has had some issues.. Ironically, I'm currently on my MEDCAP and have better internet than on the ship. Hopefully I'll post something every day while I'm here to catch you all up with everything!!


Tuesday, May 29, 2012
 We’ve been at sea now for the past 4 or 5 days. The days seem to run together out here in the middle of the Pacific, but it sure has been a fun few days! We’ve been super busy in the pharmacy since we left port in Guam. The order of the countries that we’re visiting is Indonesia, Philippines, Vietnam, and Cambodia. So it seems ironic that we finished prepacking the medications for Cambodia first and Indonesia will be the last one we do. It all has to do with politics of course since Indonesia required that we purchased the drugs from them. Therefore, we won’t be able to prepackage anything until we get close enough to have the meds helicoptered onto the ship. So when that happens in the next day or two, we will be packaging all the meds for Indonesia in a 2-day period before our treatment excursions (called MEDCAPS) begin.
MEDCAPS stands for Medical Something Something Something. We’ve learned so many acronyms in the past week that I honestly cannot remember them all! Basically, it’s where a few staff from each department are assigned to a specific location to treat the people of that city or area. For Indonesia, there are 5 MEDCAPS in which all of them are 5-day overnights. So depending on where you are assigned, you will either be staying in a ‘hotel’ or a tent for that 5-day period. I say ‘hotel’ because it could pretty much be a few pieces of wood thrown together like a shelter. The MEDCAP I have been assigned to is staying in a tent and there are still debating as to whether they will be sending a porta-potty and solar shower with us. Yep, there’s a possibility that we will not be showering for 5 days and in fact, the best advice I’ve received is that it may be wise to bring baby wipes along. I certainly am not sure what I have gotten myself into with this trip but I certainly will come out on the other side just a bit more thankful for the things I have at home.
The baby wipes thing bring up a whole other issue I’ve had on this trip. The list that Project HOPE gave us was pretty accurate but there are more than a few important pieces of info missing. I have bought more items in Guam and on the store ship than I have on souvenirs so far! It’s been really frustrating because most of the items I’ve had to purchase, I could have just brought with me if I had known! So Brittany and Dayna, I hope you’re reading this because it will definitely help when you are packing J !  You will need a long-sleeve shirt. They require it for the abandon ship drills because they don’t want you to burn. Kofi and I didn’t have it (I refused to buy one just for the drill since I knew I wouldn’t be wearing long-sleeves again any time soon!), but someone definitely noticed and said something to us about it! Also, you will need to bring some of those wall hooks that you can just stick on. They use them everywhere for hanging clothes, towels, etc since there’s no closets or doors to hang it on. You need a safety pin for your laundry bag (most random thing ever) and high-efficiency laundry detergent. I may be able to list a few other pointers as the trip goes on but those are the big things for now.
So far, I’ve learned so much but can’t even begin to describe all of it. Most of it just comes daily as I learn about the military way to do things and how they continuously change their own rules. It’s definitely been fun and I’ve already met some great friends, but I do miss home when I let my mind wander and not keep busy. There are 3 gyms on board and a library (with free phone calls!!!) so I have definitely been busy when I’m not playing cards with my peers, working in the pharmacy, and roaming the ship! Although it’s been nice to be at sea for a few days to allow us to get acquainted to everything, I’m really looking forward to arriving in Indonesia to begin the real reason behind this humanitarian mission! Hopefully I’ll be posting again before I leave for my MEDCAP since I’ll be out in the jungle for 5 days…..

The past few days have been very busy at the pharmacy. We have been working around the clock to get the medications ready for the various Medical Civic Action Programs (MEDCAPS). We received the medications for Indonesia three days ago and had to get them ready by today, when the first MEDCAP departs for the field, from the ship. The mission in Indonesia has been subdivided into five MEDCAPS, visiting five different locations in Indonesia. The readiness and availability of medications and supplies is by all intents and purposes the foundation on which the whole mission stands. It is therefore imperative that we get the medications sorted, pre-packed, labeled and ready to go as scheduled. Thankfully everybody at the pharmacy has been willing to put in long hours to ensure that these tight deadlines are met. The mission recognized our effort with this short clip of us busily at work on its website.

We have through this remarkable effort made ready, medications and supplies for 4 of the 5 MEDCAPS and are ahead of schedule for the last MEDCAP, which leaves for the Islands of Talaud on the 9th of June. I happen to be a team member on this 5th MEDCAP. We leave the ship on the morning of 9th June 2012 for the Islands of Talaud for our medical mission, staying in tents overnight for 4 nights and returning to the ship on the 13th of June. My team had an orientation yester night on the mission and our living conditions while on the field and we left the meeting with the knowledge that we will basically be living in tents and living on MREs (Meals Ready to Eat) for the length of our mission. The opportunity to touch thousands of people in these remote Islands and to deliver healthcare to them however makes these little sacrifices worthwhile, fulfilling and even exciting. Alexis is on MEDCAP 2, which departs the ship tomorrow morning for the same Islands my MEDCAP will be visiting. She will be returning to the ship on the same day my MEDCAP will be departing the ship.

I had the honor to be selected yesterday to represent the various NGOs on the ship at a dinner held in honor of Kristen Bauer, U.S Consular General (ambassador) to Surabaya, Indonesia here on the ship. At the dinner, the ambassador conveyed to us the impact of the mission, the profound gratitude of the people of Indonesia for the mission and life in Indonesia. I also had the opportunity, at the dinner to interact with some Navy Captains and medical personnel onboard the ship.

I also depart the ship tomorrow morning as part of a community relation team for a sporting event in Sulawesi with the beautiful people of Indonesia. I understand it will be a soccer match. I look forward to bringing the whole stadium alive with my soccer artistry. Stay glued here for updates of the match……